Recruitment of institutional psychiatrists for the 50 states

We studied institutional recruitment of non-federal psychiatrists in 1979 as measured by national advertisements. Vacant positions in state mental hospitals and CMHCs are over-represented in the adverts compared to the current institutional distribution of physicians practicing psychiatry. States' per capita recruitment rates vary widely, but do not decrease linearly or exponentially with increasing abundance of psychiatrists. The percentage increase sought in institutional psychiatrists ('recruitment intensity'), however, does decrease exponentially as institutional psychiatrists/100,000 population increase. Recruitment rates and recruitment intensity are not highly correlated with states' sociodemographic characteristics or with characteristics of their health care systems. Private sector recruitment, however, is significantly higher in states that have mandated psychiatric benefit packages in private insurance. Studies relating institutional recruitment or vacancy rates to measures of local demand for psychiatric services are needed, as well as comparisons of successful versus unsuccessful institutions. Institutional vacancies are undoubtedly affecting the quality of care, compliance with standards for reimbursement and ability to generate third-party revenues. Greater understanding of institutional recruitment is needed.